| NPI | 1619988508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 74039) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND 7986) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2026-06-12 |