| NPI | 1396805990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 61759) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 241807) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2020-01-28 |