| NPI | 1265466742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 0429116) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO R6N44) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2022-10-19 |