| NPI | 1932412392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 60779) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI L1828738) |
| Enumeration Date | 2010-07-14 |
| Last Update Date | 2021-03-31 |