| NPI | 1245677731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 67137) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 65552-21) |
| Enumeration Date | 2013-05-24 |
| Last Update Date | 2020-05-28 |