| NPI | 1386614709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 63350) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT D0055104) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2018-06-11 |