| NPI | 1396909701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 38644) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2017010125) |
| 207Q00000X Family Medicine (Licence: IA R8459) | |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2018-03-17 |