| NPI | 1033340567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA DO-04109) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 62118) |
| 207Q00000X Family Medicine (Licence: IA R-8696) | |
| Enumeration Date | 2009-07-31 |
| Last Update Date | 2020-05-11 |