| NPI | 1801947320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 44589) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AK 5223) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2019-11-08 |