| NPI | 1093709008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2004036182) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-31112) |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2020-05-11 |