| NPI | 1457709065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY TP474) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11018620A) |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2022-07-01 |