| NPI | 1669852638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA DO-05161) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 94-08603) |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2025-08-13 |