| NPI | 1679976799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA RN196178) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL APRN11018296) |
| 207Q00000X Family Medicine (Licence: IN 1013681A) | |
| 207Q00000X Family Medicine (Licence: TX 1041737) | |
| 207Q00000X Family Medicine (Licence: CO C-APN.00534-C) | |
| 207Q00000X Family Medicine (Licence: AZ 266107) | |
| 207Q00000X Family Medicine (Licence: MI 4704401985) | |
| 207Q00000X Family Medicine (Licence: IL 209029534) | |
| 207Q00000X Family Medicine (Licence: KY 4000104) | |
| 207Q00000X Family Medicine (Licence: NV 865209) | |
| Enumeration Date | 2014-10-02 |
| Last Update Date | 2026-01-06 |