| NPI | 1902959000 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI MD-17605) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM MD2009-0763) |
| 207Q00000X Family Medicine (Licence: NM RS2006-0356) | |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2022-11-22 |