| NPI | 1467864488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 306690) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301105579) |
| Enumeration Date | 2014-05-26 |
| Last Update Date | 2018-11-12 |