| NPI | 1235113259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 36342) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 36342) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2017-12-18 |