| NPI | 1326487703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 91836) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 82964) |
| 207Q00000X Family Medicine (Licence: MI 5101020421) | |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2022-05-26 |