| NPI | 1285686907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-32099) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2005020835) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2017-12-29 |