| NPI | 1538653134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 79367) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4351036119) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2025-05-08 |