| NPI | 1801145826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME122161) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301100961) |
| Enumeration Date | 2012-09-05 |
| Last Update Date | 2021-04-20 |