| NPI | 1104278365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 66254) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND RL14183) |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2019-11-12 |