| NPI | 1376835967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 03751) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY TP918) |
| Enumeration Date | 2011-05-14 |
| Last Update Date | 2020-08-20 |