| NPI | 1003786823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 53-84611-112) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2025014162) |
| Enumeration Date | 2025-11-06 |
| Last Update Date | 2025-11-06 |