| NPI | 1841212677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 36780) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 50488) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2008-06-16 |