| NPI | 1164494217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 46014) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 43897) |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2023-05-31 |