| NPI | 1013409267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-44902) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-11167) |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2021-07-22 |