| NPI | 1013321728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 05-38325) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 9408294) |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2017-12-29 |