| NPI | 1902033855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 26937) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: AZ 28038) |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2012-04-27 |