| NPI | 1164432381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101247971) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI CK064133) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2011-04-04 |