| NPI | 1861629511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2017-01733) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY R2139) |
| 207Q00000X Family Medicine (Licence: PA MD446450) | |
| Enumeration Date | 2009-06-19 |
| Last Update Date | 2020-10-26 |