| NPI | 1609822865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2005-00359) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301069821) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2024-12-20 |