| NPI | 1487099388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2016032807) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 0528494) |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2021-08-02 |