| NPI | 1467545863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2009020484) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 0430824) |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2026-04-14 |