| NPI | 1821319088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-35682) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 94-07437) |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2024-03-20 |