| NPI | 1568690022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-34511) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 7161) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2012-11-30 |