| NPI | 1669227211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 80341) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 34414) |
| Enumeration Date | 2024-04-18 |
| Last Update Date | 2025-07-30 |