| NPI | 1023679172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA DO-06179) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 94-10068) |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2022-10-04 |