| NPI | 1952599763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 61980-021) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101017261) |
| 207Q00000X Family Medicine (Licence: IN 02004223A) | |
| Enumeration Date | 2007-10-05 |
| Last Update Date | 2014-08-27 |