| NPI | 1629637624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ND RL15788) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 75000) |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2026-06-08 |