| NPI | 1659997302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-49671) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301509478) |
| Enumeration Date | 2020-06-18 |
| Last Update Date | 2024-08-30 |