| NPI | 1801278981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 54992) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301107152) |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2025-07-07 |