| NPI | 1255960951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-10180) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 34473) |
| Enumeration Date | 2020-04-04 |
| Last Update Date | 2022-08-01 |