| NPI | 1871700823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 10724) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 54396) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2022-04-13 |