| NPI | 1710472725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND RL15079) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND 17487) |
| Enumeration Date | 2018-06-22 |
| Last Update Date | 2026-04-19 |