| NPI | 1609030550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2012003980) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 9407063) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2024-12-31 |