| NPI | 1336669845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2021-00077) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 94-09363) |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2022-11-03 |