| NPI | 1508278367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-41587) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ R74566) |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2019-12-04 |