| NPI | 1396185492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 13993) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 64907) |
| Enumeration Date | 2013-07-03 |
| Last Update Date | 2020-06-08 |