| NPI | 1215454251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 62943) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MN 62943) |
| Enumeration Date | 2017-08-29 |
| Last Update Date | 2023-01-17 |