| NPI | 1962404707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 05-30318) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 6861) |
| 208600000X Surgery (Licence: KS 05-30318) | |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2020-05-15 |