| NPI | 1619936945 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS16295) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101009027) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2019-12-09 |