| NPI | 1245456821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 6617) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2010001130) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2015-10-30 |