| NPI | 1700847449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME125703) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301095245) |
| 207Q00000X Family Medicine (Licence: OH 35083607) | |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2016-01-06 |