| NPI | 1942425384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 10762) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 50535) |
| 207Q00000X Family Medicine (Licence: ND RL10247) | |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2020-06-08 |