| NPI | 1710241559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO182981) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101020074) |
| 207Q00000X Family Medicine (Licence: MI 5101020074) | |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2021-02-19 |