| NPI | 1598258253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 17483) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 167355) |
| 207Q00000X Family Medicine (Licence: MN 70403) | |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2023-02-23 |