| NPI | 1265511315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY KY020803) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 02808) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2023-02-09 |