| NPI | 1740254689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 41062) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 39833) |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2023-07-28 |