| NPI | 1932104098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK MEDS8281) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 21456) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2018-10-17 |