| NPI | 1275847519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 60009-20) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301097036) |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2021-11-30 |