| NPI | 1194762229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 55086) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01062177A) |
| 207Q00000X Family Medicine (Licence: KY TP834) | |
| 207Q00000X Family Medicine (Licence: KY Pending) | |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2021-03-19 |