| NPI | 1922660034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 72873) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 34807) |
| 207Q00000X Family Medicine (Licence: FL 4681) | |
| 207Q00000X Family Medicine (Licence: VA 0101275733) | |
| 207Q00000X Family Medicine (Licence: CA 199277) | |
| Enumeration Date | 2019-06-28 |
| Last Update Date | 2025-07-30 |