| NPI | 1053363473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 18170) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 0431022) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2021-09-20 |