| NPI | 1972009850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 69982) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MN 69982) |
| 207Q00000X Family Medicine (Licence: WI 7583) | |
| Enumeration Date | 2018-04-01 |
| Last Update Date | 2021-08-27 |