| NPI | 1154701084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME DO2773) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101021547) |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2025-04-01 |