| NPI | 1124381470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 59443) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND RL12382) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2015-09-11 |