| NPI | 1891175527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-40995) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-10333) |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2020-08-19 |