| NPI | 1043638083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 67431) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101020881) |
| Enumeration Date | 2014-04-06 |
| Last Update Date | 2023-12-06 |