| NPI | 1871517516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301076602) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301076602) |
| 207Q00000X Family Medicine (Licence: FL ME 100173) | |
| 207Q00000X Family Medicine (Licence: IL 036-110391) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2010-09-02 |