| NPI | 1689867129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 107105) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101016814) |
| 207Q00000X Family Medicine (Licence: NC 2011-00868) | |
| Enumeration Date | 2007-08-18 |
| Last Update Date | 2016-02-25 |