| NPI | 1083813331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 56086) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301087417) |
| 207Q00000X Family Medicine (Licence: CA A157164) | |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2022-12-21 |