| NPI | 1376808022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2015010575) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 9408012) |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2021-04-27 |