| NPI | 1174735252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 53413) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 50361) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2021-01-25 |