| NPI | 1386061430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-39976) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2017014163) |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2022-07-21 |