| NPI | 1093151540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME132952) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301103701) |
| Enumeration Date | 2013-05-10 |
| Last Update Date | 2021-02-19 |