| NPI | 1134136401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 34911) |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health (Licence: KY 34911) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2013-09-11 |