| NPI | 1942278700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 30568) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2004034265) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2020-11-19 |