| NPI | 1831184902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-26270) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO MD 103975) |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2022-01-14 |