| NPI | 1700064110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 51672) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME98845) |
| Enumeration Date | 2008-02-07 |
| Last Update Date | 2022-02-08 |