| NPI | 1548233380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI DOS-1552) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101014524) |
| 207Q00000X Family Medicine (Licence: WI 46621 021) | |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2021-02-25 |