| NPI | 1487150090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY TP554) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 52232) |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2025-07-22 |