| NPI | 1629656764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 71904) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 31710) |
| Enumeration Date | 2021-03-31 |
| Last Update Date | 2022-08-16 |