| NPI | 1396836680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-26865) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 106289) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2022-10-14 |