| NPI | 1831572262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 51398) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA getp) |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2026-01-08 |