| NPI | 1649567397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-36014) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 7760) |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2018-08-30 |