| NPI | 1861921611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 78595) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-41775) |
| 207VX0000X Obstetrics & Gynecology Obstetrics (Licence: KS 04-41775) | |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2025-04-14 |