| NPI | 1669461778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: TX K9000) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME93748) |
| 207Q00000X Family Medicine (Licence: AR E-13514) | |
| 207Q00000X Family Medicine (Licence: CT 66613) | |
| 207Q00000X Family Medicine (Licence: KY 54430) | |
| 207Q00000X Family Medicine (Licence: LA 324398) | |
| 207Q00000X Family Medicine (Licence: AK 164978) | |
| 207Q00000X Family Medicine (Licence: MO 2020030183) | |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2021-05-05 |