| NPI | 1306387071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 27501) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WY TL8766) |
| 207Q00000X Family Medicine (Licence: NC 236575) | |
| 207Q00000X Family Medicine (Licence: AZ 76141) | |
| Enumeration Date | 2017-03-15 |
| Last Update Date | 2025-07-09 |