| NPI | 1619143229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 56425) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 52530) |
| Enumeration Date | 2008-05-03 |
| Last Update Date | 2023-01-12 |