| NPI | 1063932051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 05-43555) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2017020109) |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2023-07-27 |