| NPI | 1912933128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 238794) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 36841) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2009-09-21 |