| NPI | 1275753600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 05-31851) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A8573) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2020-06-03 |