| NPI | 1487623781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT 6793) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 201801260) |
| 207Q00000X Family Medicine (Licence: ND 10884) | |
| 207Q00000X Family Medicine (Licence: OH 34.003389) | |
| 207Q00000X Family Medicine (Licence: WV 859) | |
| 207Q00000X Family Medicine (Licence: MI 2101009473) | |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2021-05-21 |