| NPI | 1467605188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-39745) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 250857) |
| Enumeration Date | 2008-10-25 |
| Last Update Date | 2023-12-30 |