| NPI | 1033290861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 66505) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 39820) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2020-11-10 |