| NPI | 1720308570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: 5385) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK OK-5385) |
| 261QP0904X Clinic/Center, Public Health, Federal | |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2024-12-06 |