| NPI | 1366822587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 60805) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2022008365) |
| 208D00000X General Practice (Licence: MN 60805) | |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2024-10-09 |