| NPI | 1982803334 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 37444) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 103522) |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2019-07-31 |