| NPI | 1891373049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 72119) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 31609) |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2022-08-25 |