| NPI | 1871226225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 74698) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 32928) |
| Enumeration Date | 2022-07-04 |
| Last Update Date | 2023-08-03 |