| NPI | 1295255289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2003-02607) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-43491) |
| 208D00000X General Practice (Licence: PR 32831) | |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2024-09-13 |