| NPI | 1558399014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 05-34354) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2010001784) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2023-03-07 |