| NPI | 1073740759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 55480) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R8650) |
| Enumeration Date | 2009-06-19 |
| Last Update Date | 2017-07-18 |