| NPI | 1427438092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 64305) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-10334) |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2021-06-10 |