| NPI | 1750316204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 30624) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301086486) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2012-08-29 |