| NPI | 1659582542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 200300618) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 92507) |
| 207Q00000X Family Medicine (Licence: IL 036-079285) | |
| 207Q00000X Family Medicine (Licence: IN 01036852A) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: IL 036-079285) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: OH 92507) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: IN 01036852A) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: NC 200300618) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2013-03-05 |