| NPI | 1821018391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 14235) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 200101463) |
| 207Q00000X Family Medicine (Licence: AK 5137) | |
| 207Q00000X Family Medicine (Licence: MI 4301093180) | |
| 207Q00000X Family Medicine (Licence: ME TD101073) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2010-12-16 |