| NPI | 1467622787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 55877) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301090039) |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2025-09-08 |