| NPI | 1215552096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 73306) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE TEP8726) |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2023-08-11 |