| NPI | 1265487789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 025945) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS 26220) |
| 207Q00000X Family Medicine (Licence: NM Md2018-0193) | |
| 207Q00000X Family Medicine (Licence: FL me90266) | |
| 207Q00000X Family Medicine (Licence: WI 69498-20) | |
| 207Q00000X Family Medicine (Licence: IL 036.139516) | |
| 207Q00000X Family Medicine (Licence: NE 28930) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2023-04-26 |