| NPI | 1770711871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 076067) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301100044) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2018-12-13 |