| NPI | 1508020165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2009018145) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 50949) |
| 207Q00000X Family Medicine (Licence: KS 05-39885) | |
| 207QB0002X Family Medicine, Bariatric Medicine (Licence: KS 05-39885) | |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2022-12-05 |