NPI | 1861484875 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 23548) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 63197) |
Enumeration Date | 2005-08-16 |
Last Update Date | 2020-11-03 |