| NPI | 1598058943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2014012420) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 05-37167) |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2017-01-19 |