| NPI | 1427054329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 36703) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 37049) |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2025-09-29 |