| NPI | 1386611457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2003014839) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 0432451) |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2024-01-30 |