| NPI | 1902069800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 45638) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01067640A) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2018-04-13 |