| NPI | 1528018728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY C1577) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 26526) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2023-11-16 |