| NPI | 1154302438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 52506) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301084852) |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2013-10-30 |