| NPI | 1871548719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 48062) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 34578) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2013-09-06 |