| NPI | 1528328960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 47736) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY R2890) |
| Enumeration Date | 2012-05-19 |
| Last Update Date | 2015-05-26 |