| NPI | 1235251562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 4343) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 48365) |
| 207Q00000X Family Medicine (Licence: AK 4217) | |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2018-09-06 |