| NPI | 1639743743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 9341) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 9500020) |
| Enumeration Date | 2021-05-14 |
| Last Update Date | 2024-08-27 |