| NPI | 1518305267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 0442418) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2016028754) |
| 261QP2300X Clinic/Center, Primary Care (Licence: KS 442418) | |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2024-07-25 |