| NPI | 1780090233 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 51573) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 7337) |
| Enumeration Date | 2014-07-05 |
| Last Update Date | 2021-04-21 |