| NPI | 1316236466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID O-0918) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101019275) |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2024-12-23 |