| NPI | 1700268356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D086107) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY R3803) |
| 207Q00000X Family Medicine (Licence: MD D86107) | |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2019-01-23 |