| NPI | 1508827130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 33475) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 40624 020) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2011-12-05 |