| NPI | 1033376918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME129040) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301092853) |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2021-11-23 |