| NPI | 1225113558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 34647) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2001-00913) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2022-11-15 |