| NPI | 1255443966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 55549) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 41550) |
| 207Q00000X Family Medicine (Licence: HI MD16849) | |
| 207Q00000X Family Medicine (Licence: ID M-9727) | |
| 207Q00000X Family Medicine (Licence: WA MD00047237) | |
| 207Q00000X Family Medicine (Licence: TX N2929) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2016-08-08 |