| NPI | 1003127028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5315057954) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301096940) |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2023-03-23 |