| NPI | 1063403525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 35847) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-21351) |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2025-01-10 |