| NPI | 1790927549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 0533813) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2006016929) |
| Enumeration Date | 2009-03-25 |
| Last Update Date | 2009-09-10 |