| NPI | 1215981980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2008022991) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-31545) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2016-09-02 |