| NPI | 1992153910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-42574) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AK 110874) |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2019-09-27 |