| NPI | 1114972833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 40370) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-21069) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2017-04-19 |