| NPI | 1003604836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 83351) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 35139) |
| Enumeration Date | 2025-04-30 |
| Last Update Date | 2026-07-30 |