| NPI | 1699793265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 52278) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND 5823) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2019-07-31 |