| NPI | 1205088515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 12005) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101017842) |
| Enumeration Date | 2008-10-17 |
| Last Update Date | 2024-05-15 |