| NPI | 1922102276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-21592) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 0421592) |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2020-10-23 |