| NPI | 1871502740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 9395) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 46245) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2021-10-28 |