| NPI | 1093821779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 0425079) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH 21817) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2022-09-15 |