| NPI | 1619408051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 95545) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5151013349) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2023-09-06 |