| NPI | 1043320484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-41400) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 31672) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2018-10-30 |