| NPI | 1497194781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 0439378) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2013017864) |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2020-06-10 |