| NPI | 1982962874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 03792) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY R2876) |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2015-07-02 |