| NPI | 1396044764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 35112) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 96174) |
| 207Q00000X Family Medicine (Licence: IN 01091045A) | |
| 207Q00000X Family Medicine (Licence: TN 69101) | |
| 207Q00000X Family Medicine (Licence: TX U4713) | |
| 207Q00000X Family Medicine (Licence: WA MD61447296) | |
| 207Q00000X Family Medicine (Licence: IL 036164835) | |
| 207Q00000X Family Medicine (Licence: AL 46834) | |
| 207Q00000X Family Medicine (Licence: CA C176266) | |
| 207Q00000X Family Medicine (Licence: WI 3213-320) | |
| 207Q00000X Family Medicine (Licence: WY 15921C) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: VA 0101258345) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: OK 35112) | |
| Enumeration Date | 2011-03-23 |
| Last Update Date | 2024-05-13 |