| NPI | 1003000902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 41402) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01063381A) |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2020-12-08 |