| NPI | 1255315198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 29065) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301070217) |
| 207Q00000X Family Medicine (Licence: AL MD29065) | |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2023-08-04 |