| NPI | 1336942689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 83152) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 35255) |
| Enumeration Date | 2025-03-31 |
| Last Update Date | 2026-07-29 |