| NPI | 1710916630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 26729) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI SS081690) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2014-05-06 |