| NPI | 1770140121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-46665) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 94-09829) |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2022-08-29 |