| NPI | 1144755323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 64225) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301501881) |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2022-04-13 |