| NPI | 1598950743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 57583) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 24037) |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2018-03-17 |