| NPI | 1295732519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 3449) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 46545) |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2010-10-19 |