| NPI | 1386379147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 80474) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND 18679) |
| Enumeration Date | 2022-07-17 |
| Last Update Date | 2025-09-03 |