| NPI | 1174720148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 05-33473) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 05-33473) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2024-01-31 |