| NPI | 1700199049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 59980) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 04387) |
| Enumeration Date | 2010-07-15 |
| Last Update Date | 2015-12-09 |