| NPI | 1619297744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 68690) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX P7014) |
| 207Q00000X Family Medicine (Licence: MI 5101027723) | |
| 207Q00000X Family Medicine (Licence: IN 02007575A) | |
| 207Q00000X Family Medicine (Licence: NY 326504-01) | |
| 207R00000X Internal Medicine (Licence: KY 05699) | |
| Enumeration Date | 2010-06-11 |
| Last Update Date | 2025-02-24 |