| NPI | 1780027938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 59851) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 64805) |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2024-08-08 |