| NPI | 1396905998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 03156) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY R1335) |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2016-11-08 |