| NPI | 1114153368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 55121) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-8563) |
| Enumeration Date | 2009-06-02 |
| Last Update Date | 2022-11-07 |