| NPI | 1215007414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101015216) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN MN52471) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2012-02-09 |