| NPI | 1487693818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q0285) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.074667) |
| 207Q00000X Family Medicine (Licence: KY 55504) | |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2021-07-26 |