| NPI | 1326493289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2024-01311) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 58464) |
| 207Q00000X Family Medicine (Licence: WA MD61422193) | |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2024-09-09 |