| NPI | 1376956979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2023026696) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 94-10429) |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2023-09-11 |