| NPI | 1972577898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 43027) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 31705) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2023-05-31 |