| NPI | 1275703118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60956309) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM MD2009-0172) |
| 207Q00000X Family Medicine (Licence: CA A102973) | |
| Enumeration Date | 2008-03-06 |
| Last Update Date | 2022-03-18 |