| NPI | 1992184766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-41610) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2018037844) |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2020-10-21 |