| NPI | 1629652425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: MN 75705) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 75705) |
| Enumeration Date | 2021-05-07 |
| Last Update Date | 2026-06-15 |