| NPI | 1780879718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-35106) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2022-00941) |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2024-03-01 |