| NPI | 1396772943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 0423744) |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: KS 0423744) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2025-11-11 |