| NPI | 1891759064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 43395) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 30565020) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2023-11-06 |