| NPI | 1972703379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 43776) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 253553) |
| 207Q00000X Family Medicine (Licence: CO DR45201) | |
| 207Q00000X Family Medicine (Licence: KY TP279) | |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2024-05-23 |