| NPI | 1881645356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care (Licence: MN 40756) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 40756) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2025-11-24 |