| NPI | 1801813571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 9203) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 41674) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2011-11-29 |