| NPI | 1588620728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 7567) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 46226) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2015-12-28 |