| NPI | 1770725343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: FL ME105517) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 082061) |
| 207Q00000X Family Medicine (Licence: DE C10013010) | |
| 207Q00000X Family Medicine (Licence: OH 35.135131) | |
| 207Q00000X Family Medicine (Licence: TN 58484) | |
| 207Q00000X Family Medicine (Licence: CO DR.0071935) | |
| 207QA0505X Family Medicine, Adult Medicine (Licence: NC 202303017) | |
| 207QA0505X Family Medicine, Adult Medicine (Licence: PA MD436387) | |
| 207QA0505X Family Medicine, Adult Medicine (Licence: NY 307372) | |
| Enumeration Date | 2009-03-29 |
| Last Update Date | 2023-11-10 |