| NPI | 1417453366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 65974) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MN 65974) |
| Enumeration Date | 2018-03-31 |
| Last Update Date | 2022-11-07 |