| NPI | 1972629749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-34611) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2020008252) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2025-10-01 |