| NPI | 1366461741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 0550484) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX K8686) |
| 207Q00000X Family Medicine (Licence: FL OS17772) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2025-04-17 |