| NPI | 1275531352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 33350) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME107532) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2025-08-15 |