| NPI | 1295090942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2019-02631) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 9408008) |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2022-06-06 |