| NPI | 1255383881 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 03284) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS 12919) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2023-05-25 |