| NPI | 1518956523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 49418) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI CS085188) |
| 207Q00000X Family Medicine (Licence: NM MD2010-0685) | |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2019-06-11 |