| NPI | 1386787950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-33260) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 206018068) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2021-09-02 |