| NPI | 1295928091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 47628) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND 9164) |
| Enumeration Date | 2007-08-24 |
| Last Update Date | 2015-08-05 |