| NPI | 1700517463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 74682) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 32687) |
| Enumeration Date | 2022-06-22 |
| Last Update Date | 2023-07-27 |