| NPI | 1265518567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 84792) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301092485) |
| 207Q00000X Family Medicine (Licence: MI L2114580) | |
| 207Q00000X Family Medicine (Licence: KS 0431966) | |
| Enumeration Date | 2006-10-29 |
| Last Update Date | 2020-09-11 |