| NPI | 1215632575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 80271) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 34315) |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2026-08-13 |