| NPI | 1255521589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 0424251) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 112133) |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2020-04-22 |