| NPI | 1114947488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2012010199) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 531276) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2017-10-30 |