| NPI | 1427046937 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 40745) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301074827) |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2020-10-26 |