| NPI | 1689814675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: KY 03387) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 03387) |
| 208000000X Pediatrics (Licence: KY 03387) | |
| Enumeration Date | 2009-03-03 |
| Last Update Date | 2021-08-10 |