| NPI | 1770666174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 57044) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 43085) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2023-01-16 |