| NPI | 1760442065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 44707) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 47073) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2013-02-06 |