| NPI | 1386873578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 05-38983) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 5698) |
| 207Q00000X Family Medicine (Licence: MO 2014029496) | |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2023-03-07 |