| NPI | 1619920220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 115612) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 0429307) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2021-11-01 |