| NPI | 1003348095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 9409365) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2021022625) |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2022-10-26 |