| NPI | 1013118173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 51462) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 58.001571) |
| 207Q00000X Family Medicine (Licence: WA OP00002244) | |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2011-10-10 |