| NPI | 1972549970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2011-0759) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC MD16115) |
| 207Q00000X Family Medicine (Licence: NC 9701248) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2024-08-26 |