| NPI | 1023528155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 69941) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD61099145) |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2024-05-20 |