| NPI | 1891879094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M7802) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 101703) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2016-02-23 |