| NPI | 1225002165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 20783) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 36090) |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2009-12-21 |