| NPI | 1396108205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 65744) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 68261) |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2024-09-25 |