| NPI | 1073755195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME161471) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 76552) |
| 207Q00000X Family Medicine (Licence: MI 4301095380) | |
| Enumeration Date | 2009-04-03 |
| Last Update Date | 2023-04-04 |