| NPI | 1780629543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI 16883) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 30953) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2017-08-25 |