| NPI | 1053419861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-42166) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND 7753) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2022-01-07 |