| NPI | 1912990607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 25961) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 25961) |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2022-09-01 |