| NPI | 1306293402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-40518) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 94-08886) |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2019-04-19 |