| NPI | 1740694850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS16250) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101021127) |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2024-09-09 |