| NPI | 1841687365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 70613) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 66246-20) |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2022-04-05 |