| NPI | 1518254366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 63662) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 5932) |
| 207Q00000X Family Medicine (Licence: AZ 11239) | |
| 207Q00000X Family Medicine (Licence: CO CDR.0004245) | |
| 207Q00000X Family Medicine (Licence: WI 3035-321) | |
| 207Q00000X Family Medicine (Licence: SC 1490) | |
| 207Q00000X Family Medicine (Licence: IA DO-04903) | |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2024-09-20 |