| NPI | 1144547027 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 60199) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 54126) |
| Enumeration Date | 2010-04-30 |
| Last Update Date | 2025-04-24 |