| NPI | 1609258243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-47891) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL38270) |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2023-09-22 |