| NPI | 1720315906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 57783) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT195056) |
| 207Q00000X Family Medicine (Licence: SC MD34576) | |
| Enumeration Date | 2009-11-10 |
| Last Update Date | 2020-03-25 |