| NPI | 1861838245 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 05-38183) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 9408081) |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2016-09-12 |