| NPI | 1245644814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 79086) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS 25232) |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2025-08-14 |