| NPI | 1063725273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 47825) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 50146) |
| 207Q00000X Family Medicine (Licence: PA MT197438) | |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2020-10-27 |