| NPI | 1306810460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2007-01399) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301065153) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2021-08-21 |