| NPI | 1205858040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.133256) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS KS 04-31188) |
| 207Q00000X Family Medicine (Licence: KS 31188) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2022-01-31 |