| NPI | 1598729394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-28362) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 120034) |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2021-05-06 |