| NPI | 1821559774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 05273) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: KY 05273) |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2022-10-17 |