| NPI | 1780067660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD185697) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301108416) |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2024-01-02 |