| NPI | 1831521848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 59477) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A126523) |
| Enumeration Date | 2013-07-31 |
| Last Update Date | 2020-11-10 |