| NPI | 1932776762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 95-00013) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 94-10645) |
| Enumeration Date | 2021-06-09 |
| Last Update Date | 2023-07-06 |