| NPI | 1952806192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2020032472) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 0543886) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2022-12-23 |