| NPI | 1235211236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 46784) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A54812) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2014-12-30 |