| NPI | 1447240924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 25771) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 23706) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2018-07-30 |