| NPI | 1568506749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY R1453) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY R1453) |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2012-04-05 |