| NPI | 1093154403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 62806) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 64489) |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2023-06-14 |