| NPI | 1194169268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 73864) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 63412-20) |
| 207Q00000X Family Medicine (Licence: MT 59318) | |
| Enumeration Date | 2013-04-19 |
| Last Update Date | 2023-08-17 |