| NPI | 1659452902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 56735) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OP60094132) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2020-11-10 |