| NPI | 1710142740 |
|---|---|
| Former Name | MONICA ANN GRUNKEMEYER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 56087-20) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036126673) |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2021-03-03 |