| NPI | 1710482419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-48499) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2021036810) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2024-10-28 |