| NPI | 1326062183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS12723) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 0553) |
| 207Q00000X Family Medicine (Licence: AL DO445) | |
| 207Q00000X Family Medicine (Licence: OK 3398) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2019-11-25 |