| NPI | 1427312529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 60916) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE TEP6764) |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2020-12-01 |