| NPI | 1487920211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AK 108662) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AK 108662) |
| 208D00000X General Practice (Licence: AK 108662) | |
| 261QR1300X Clinic/Center, Rural Health | |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2019-06-07 |