| NPI | 1487217592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 79386) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT 127227) |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2025-05-05 |