| NPI | 1114314358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 62938) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND PT14996) |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2018-09-06 |