| NPI | 1982876850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM A1613-11) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO 10323) |
| 183500000X Pharmacist (Licence: MI 5302022386) | |
| 207Q00000X Family Medicine (Licence: MI 5101010598) | |
| 207Q00000X Family Medicine (Licence: NM A-1613-11) | |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2019-10-24 |