| NPI | 1770529844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SD 7820) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 47323) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2010-08-09 |