| NPI | 1376668210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 38317) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 37338) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2023-04-05 |