| NPI | 1033523527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60758762) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI L266022) |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2022-07-21 |