| NPI | 1396008231 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT 51643) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 60964) |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2023-11-27 |