| NPI | 1831766807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-49865) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 94-10666) |
| Enumeration Date | 2021-06-08 |
| Last Update Date | 2025-06-17 |