| NPI | 1477794311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 0434338) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2009012454) |
| Enumeration Date | 2009-03-23 |
| Last Update Date | 2010-11-15 |