| NPI | 1770551335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 50745) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 47604) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2024-01-29 |