| NPI | 1013399112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 66330) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 66330) |
| 207Q00000X Family Medicine (Licence: MO 2015018606) | |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2019-09-12 |