| NPI | 1629569850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 65239) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY TP209) |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2024-04-16 |