| NPI | 1295783884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 37490) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01055090A) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2019-10-07 |