| NPI | 1659416493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 03103) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11012827) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2008-08-12 |