| NPI | 1073704375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 63282) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 50160) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2024-03-05 |