| NPI | 1356358444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 61811) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND 18938) |
| 207Q00000X Family Medicine (Licence: MN 72433) | |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2024-11-26 |