| NPI | 1306042148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS11766) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101017454) |
| 207Q00000X Family Medicine (Licence: PA OS016036) | |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2019-03-26 |