| NPI | 1730193442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 48645) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 51958-20) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2022-07-21 |