| NPI | 1144202730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA MD-38737) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-32649) |
| 207Q00000X Family Medicine (Licence: MN 52075) | |
| 207Q00000X Family Medicine (Licence: WI 48402) | |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2023-05-03 |