| NPI | 1770777161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 05-33527) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 14878) |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2021-08-08 |