| NPI | 1831940949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 80333) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 34393) |
| Enumeration Date | 2024-03-27 |
| Last Update Date | 2025-09-02 |