| NPI | 1588771778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 46480) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101012908) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2023-05-10 |