| NPI | 1518189463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 49783) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 53211) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2025-03-19 |