| NPI | 1386955771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD210848) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301096950) |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2022-06-20 |