| NPI | 1659505113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 03404) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 02005817A) |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2024-02-19 |