| NPI | 1588352371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 77522) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 33426) |
| Enumeration Date | 2023-04-28 |
| Last Update Date | 2024-08-23 |