| NPI | 1669760864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 16104) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301099538) |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2015-10-28 |