| NPI | 1982191250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 68880) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101025197) |
| Enumeration Date | 2018-04-22 |
| Last Update Date | 2021-07-27 |