| NPI | 1194796441 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 0447050)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO MD 2001013353)  | 
| 207Q00000X Family Medicine (Licence: MO 2001013353)  | |
| Enumeration Date | 2006-01-26 | 
| Last Update Date | 2022-12-15 |