| NPI | 1609040054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 51096) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI dos 1281) |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2020-01-29 |