| NPI | 1457475410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 12916) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ MD40202) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2022-10-18 |