| NPI | 1386175925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 52883) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101283797) |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2024-11-25 |