| NPI | 1386616704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 46532) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SD 5682) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2022-04-06 |