| NPI | 1265793707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 72186) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101259020) |
| 207Q00000X Family Medicine (Licence: FL 17568) | |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2024-07-30 |