| NPI | 1881860443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 52098) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 54122) |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2020-07-22 |