| NPI | 1659900140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2023008317) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-47903) |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2023-08-26 |