| NPI | 1891971628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 42393) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 81714) |
| 207Q00000X Family Medicine (Licence: MI 4301095410) | |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2025-10-23 |