Individual
PEI MI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D, PH.D, MPH
Taxonomy
Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
54788
MN
Other
Enumeration date
05/14/2010
Last updated
02/06/2014
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