| NPI | 1033256110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 26900) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 260963) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2018-02-28 |