| NPI | 1750605408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 66112) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ R71863) |
| 207Q00000X Family Medicine (Licence: MI 4301101891) | |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2022-08-31 |