| NPI | 1679554836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 36902) |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: CO 46948) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2023-08-08 |