| NPI | 1679505598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E9671) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 215401) |
| 207Q00000X Family Medicine (Licence: CO 39244) | |
| 207Q00000X Family Medicine (Licence: LA 206622) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2021-01-05 |