| NPI | 1891144085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 65191) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM R-15-2016) |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2019-05-16 |