| NPI | 1144411596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY R1579) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 42753) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2020-02-19 |