| NPI | 1306200407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 05-46957) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2016021109) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2022-12-07 |