| NPI | 1801835871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-30435) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2003022695) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2025-08-08 |