| NPI | 1396234605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301507671) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AK 133482) |
| 207Q00000X Family Medicine (Licence: MO 2021025256) | |
| Enumeration Date | 2018-05-02 |
| Last Update Date | 2022-11-02 |