| NPI | 1346627049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 05-41119) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2020027254) |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2023-02-03 |