| NPI | 1215374152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 42158) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 60069) |
| Enumeration Date | 2013-06-02 |
| Last Update Date | 2022-06-30 |