| NPI | 1356363691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-31292) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 70416) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2022-02-03 |