| NPI | 1407808439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 0429444) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2022016885) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2022-08-18 |