| NPI | 1003853847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 065552) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 39544) |
| 207Q00000X Family Medicine (Licence: GA 65552) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2022-01-10 |