| NPI | 1235156845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 7182) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 37818) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2011-11-29 |