| NPI | 1730353830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N3752) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301097539) |
| 207Q00000X Family Medicine (Licence: IN 01065086A) | |
| 207Q00000X Family Medicine (Licence: NY 249505) | |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2019-05-16 |