| NPI | 1053402354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL 12339) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-23296) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2024-08-01 |