| NPI | 1740216340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 51292) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 19617) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2022-07-13 |