| NPI | 1770641300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301086165) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 047253) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2013-03-14 |