| NPI | 1619267887 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO202660) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 59982) |
| Enumeration Date | 2011-04-08 |
| Last Update Date | 2024-05-06 |