| NPI | 1033477088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 2791) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY TP056) |
| 207Q00000X Family Medicine (Licence: KY 04205) | |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2021-04-20 |