| NPI | 1871779488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 41487) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01065560A) |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2021-09-17 |