| NPI | 1003015314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 14577) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 52168) |
| 207Q00000X Family Medicine (Licence: ND PT14577) | |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2022-07-21 |