| NPI | 1609855873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 47666) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND 10769) |
| Enumeration Date | 2006-01-16 |
| Last Update Date | 2024-09-10 |