| NPI | 1609305424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-43382) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-10898) |
| 207Q00000X Family Medicine (Licence: IA MD-45478) | |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2020-10-07 |