| NPI | 1518349190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 04301) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY R3787) |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2021-08-24 |