| NPI | 1437145695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY KY26442) |
| Additional Taxonomies | 208D00000X General Practice (Licence: KY 26442) |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2018-12-05 |