| NPI | 1790921914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 05-41757) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2016015924) |
| 207Q00000X Family Medicine (Licence: PA OS015504) | |
| Enumeration Date | 2008-12-17 |
| Last Update Date | 2021-11-29 |