| NPI | 1629708177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2025030285) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 9410932) |
| Enumeration Date | 2022-06-15 |
| Last Update Date | 2025-08-19 |