| NPI | 1225599269 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 22465) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 30209) |
| 207Q00000X Family Medicine (Licence: MN 68187) | |
| Enumeration Date | 2019-03-30 |
| Last Update Date | 2022-07-19 |