| NPI | 1255331401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 32543) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 02475) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2023-09-05 |