| NPI | 1073650024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0065228) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301084216) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2022-02-04 |