| NPI | 1881980746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 006738) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101019187) |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2015-09-22 |