| NPI | 1891706263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 50395) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-7613) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2023-11-09 |