| NPI | 1316387467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 60483) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301103189) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2016-07-22 |