| NPI | 1386801124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101244115) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 48635) |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2017-05-05 |