| NPI | 1689648255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 24369) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 22032) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2021-03-11 |