| NPI | 1043267404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO R3H32) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-28042) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2022-08-05 |