| NPI | 1588627277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 37544) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0037669) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2007-07-08 |