| NPI | 1104860287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2006006975) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 0532427) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2009-12-07 |