| NPI | 1619590270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2023028734) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 05-48103) |
| Enumeration Date | 2020-05-18 |
| Last Update Date | 2023-10-03 |