| NPI | 1205270246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 63097) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 61293) |
| 207Q00000X Family Medicine (Licence: WA MD60751685) | |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2024-09-19 |