| NPI | 1487913125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301100566) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 1667-320) |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2024-01-02 |