| NPI | 1457587602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2015041241) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 05-37491) |
| Enumeration Date | 2009-06-02 |
| Last Update Date | 2020-12-14 |