| NPI | 1184187809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD206160) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301509506) |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2024-04-19 |