| NPI | 1336430180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 55903) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA DO-04618) |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2020-09-17 |