| NPI | 1194045526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301104250) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MI 4301104250) |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2025-06-12 |