| NPI | 1619956067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 27680) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 38164) |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2023-03-14 |