| NPI | 1952362493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN R0678432) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 62336) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2008-03-20 |