| NPI | 1538230065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 49168) |
| Additional Taxonomies | 208600000X Surgery (Licence: KY 49168) |
| 208D00000X General Practice (Licence: KY 49168) | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2026-08-25 |