| NPI | 1649462755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: DC MD038198) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0063089) |
| 207Q00000X Family Medicine (Licence: KY 45081) | |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2015-10-13 |