| NPI | 1649246836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK 651-AK) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AK 651-AK) |
| 261QU0200X Clinic/Center, Urgent Care (Licence: AK 651-AK) | |
| 363AM0700X Physician Assistant, Medical (Licence: AK 651) | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2023-03-07 |