| NPI | 1184690448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 51732-20) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301080132) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2018-11-05 |