| NPI | 1497109755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 69806) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VT 042.0014507) |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2022-09-13 |