| NPI | 1417054040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 23527) |
| Additional Taxonomies | 2083X0100X Preventive Medicine Occupational Medicine (Licence: KY 23527) |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2010-10-08 |