| NPI | 1518079300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 29143) |
| Additional Taxonomies | 207QA0000X Family Medicine Adolescent Medicine (Licence: KY 29143) |
| 207QA0401X Family Medicine Addiction Medicine (Licence: KY 29143) | |
| 207QA0505X Family Medicine Adult Medicine (Licence: KY 29143) | |
| 207QG0300X Family Medicine Geriatric Medicine (Licence: KY 29143) | |
| 207QS0010X Family Medicine Sports Medicine (Licence: KY 29143) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2008-02-22 |