| NPI | 1285012674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 80968) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A19273) |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2026-05-12 |