| NPI | 1891704417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 46752) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101014919) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2016-05-23 |