| NPI | 1144745308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 12483) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 12483) |
| Enumeration Date | 2017-08-09 |
| Last Update Date | 2024-05-06 |