| NPI | 1700806833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 49516) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 42393) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2012-06-16 |