| NPI | 1003879586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 45808) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 45808) |
| 207Q00000X Family Medicine (Licence: GA 053748) | |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2021-01-15 |