| NPI | 1922489871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 84569-20) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301108087) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: MA 1014198) | |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2024-12-04 |