| NPI | 1184750796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-32359) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2005019460) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2023-09-22 |