NPI | 1518902840 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0000X Family Medicine Adolescent Medicine (Licence: KY 28861) |
Additional Taxonomies | 207QA0401X Family Medicine Addiction Medicine (Licence: KY 28861) |
207QA0505X Family Medicine Adult Medicine (Licence: KY 28861) | |
207QG0300X Family Medicine Geriatric Medicine (Licence: KY 28861) | |
207QS0010X Family Medicine Sports Medicine (Licence: KY 28861) | |
Enumeration Date | 2006-06-19 |
Last Update Date | 2019-02-27 |