| NPI | 1881153955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2024-02722) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD61309883) |
| 207Q00000X Family Medicine (Licence: MN 70242) | |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2024-09-26 |