| NPI | 1235798752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4351045518) |
| Additional Taxonomies | 174N00000X Lactation Consultant, Non-RN (Licence: MI L-320987) |
| Enumeration Date | 2019-06-08 |
| Last Update Date | 2026-06-30 |