| NPI | 1356871693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 67554) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID MRM-1662) |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2022-07-21 |