| NPI | 1376925610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301508549) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MI 1014327) |
| 207Q00000X Family Medicine (Licence: MI 4351046380) | |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2023-08-01 |