| NPI | 1114091964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301508200) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2005013260) |
| 207Q00000X Family Medicine (Licence: IN 01067729A) | |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2023-09-26 |