| NPI | 1417139601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301065913) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 97570) |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2025-08-19 |