| NPI | 1194054197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301514141) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME 113965) |
| Enumeration Date | 2009-12-22 |
| Last Update Date | 2025-08-06 |