| NPI | 1578543138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 22713) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: KY 22713) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2020-07-13 |