| NPI | 1730314253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 64349-21) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI KP018428) |
| Enumeration Date | 2009-05-28 |
| Last Update Date | 2015-12-02 |