| NPI | 1134308745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 05-38982) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2010009594) |
| Enumeration Date | 2007-10-31 |
| Last Update Date | 2026-01-14 |