| NPI | 1679749253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2012-01918) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 24482) |
| 207Q00000X Family Medicine (Licence: TX S3814) | |
| 207Q00000X Family Medicine (Licence: IN 01081378A) | |
| 207Q00000X Family Medicine (Licence: VA 0101267250) | |
| 207Q00000X Family Medicine (Licence: RI MD16468) | |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2020-01-22 |