| NPI | 1003034281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 22598) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35120427) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-08-10 |