| NPI | 1174938179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 05-39547) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 94-08466) |
| Enumeration Date | 2014-06-27 |
| Last Update Date | 2022-07-21 |