| NPI | 1760449763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 64267) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 45981) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2017-02-02 |