| NPI | 1194164327 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 285825) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301115076) |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2025-05-09 |