| NPI | 1679034888 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 68293) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 30242) |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2020-10-12 |