| NPI | 1841853900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 71799) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-11433) |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2022-07-20 |