| NPI | 1225072002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301077544) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 1603) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2022-04-20 |