| NPI | 1851038681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care (Licence: MN 74885) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 32591) |
| Enumeration Date | 2022-05-13 |
| Last Update Date | 2025-11-07 |