| NPI | 1295795342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 30884) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AK 2657) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2008-06-13 |