| NPI | 1629539739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 78573) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2021029003) |
| 207Q00000X Family Medicine (Licence: KS 04-46424) | |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2025-02-04 |