| NPI | 1356785141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 03913) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY R3203) |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2016-06-08 |