| NPI | 1255325973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 0432534) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2004019667) |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2024-05-03 |