| NPI | 1154941300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 70566) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OP61614006) |
| Enumeration Date | 2020-04-17 |
| Last Update Date | 2024-10-11 |