| NPI | 1063824266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 60853) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND RL13251) |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2022-04-29 |