| NPI | 1043303845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 21933) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: KY 21933) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2010-10-26 |