| NPI | 1275024663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 70152) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-11163) |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2021-10-18 |