| NPI | 1821356684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35142345) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 61704) |
| 207Q00000X Family Medicine (Licence: MI 4301108646) | |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2021-09-15 |