| NPI | 1356970149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 83345) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 81531) |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2026-09-02 |