| NPI | 1740544873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101021887) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2012020881) |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2023-07-13 |