| NPI | 1548239056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 22676) |
| Additional Taxonomies | 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: MN 22676) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2008-04-20 |