| NPI | 1699766055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN PY 43615) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 43615) |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2017-11-28 |