| NPI | 1033401906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD166221) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301098123) |
| Enumeration Date | 2011-05-10 |
| Last Update Date | 2023-02-10 |