| NPI | 1407854177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301060801) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MI 4301060801) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2018-11-08 |