| NPI | 1720245442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-34110) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2007016084) |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2022-08-05 |