| NPI | 1710476023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 78695) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AK 133289) |
| Enumeration Date | 2018-05-02 |
| Last Update Date | 2025-08-18 |