| NPI | 1326784638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 33568) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MN 33568) |
| Enumeration Date | 2022-05-10 |
| Last Update Date | 2023-05-25 |