| NPI | 1992968291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 71899) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 663) |
| 207Q00000X Family Medicine (Licence: IL 036136195) | |
| 207Q00000X Family Medicine (Licence: NC 2018-01846) | |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2023-01-10 |