| NPI | 1679212401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 77331) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND 18554) |
| Enumeration Date | 2022-05-31 |
| Last Update Date | 2024-08-15 |