| NPI | 1194187278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 52873) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY R4145) |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2020-10-26 |