| NPI | 1932101631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2011027717) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-29201) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2022-09-22 |