| NPI | 1447477625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 45679) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC MD29456) |
| 208D00000X General Practice (Licence: LA MD200113) | |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2023-03-07 |