| NPI | 1013368968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 52925) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11018785A) |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2019-10-15 |