| NPI | 1245642537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 0437998) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 94-08341) |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2019-03-08 |