| NPI | 1053374488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 43621) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA DO-04539) |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2024-09-17 |