| NPI | 1720021280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX L5820) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI MD-20032) |
| 207Q00000X Family Medicine (Licence: NM MD2018-0897) | |
| 207Q00000X Family Medicine (Licence: CA C159199) | |
| 207Q00000X Family Medicine (Licence: OR MD190704) | |
| 207Q00000X Family Medicine (Licence: AK 138925) | |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2019-08-22 |