| NPI | 1083274005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-45022) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 94-09935) |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2022-01-24 |