| NPI | 1205805777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 26986) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 51028) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2023-04-04 |