| NPI | 1174754832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2009028449) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 05-45805) |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2025-11-10 |