| NPI | 1609844935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 50279) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SD 3570) |
| 207Q00000X Family Medicine (Licence: IA MD52478) | |
| Enumeration Date | 2006-03-11 |
| Last Update Date | 2024-06-12 |