| NPI | 1881814846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2012-01634) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301092072) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2021-08-10 |