| NPI | 1962145995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 74652) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 32594) |
| Enumeration Date | 2022-04-18 |
| Last Update Date | 2024-01-16 |