| NPI | 1871857276 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME125082) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.134448) | 
| 207Q00000X Family Medicine (Licence: KY 51687) | |
| 207Q00000X Family Medicine (Licence: GA 081653) | |
| 207Q00000X Family Medicine (Licence: TN 57992) | |
| 207Q00000X Family Medicine (Licence: DE C10012939) | |
| Enumeration Date | 2012-06-29 | 
| Last Update Date | 2019-09-11 |