| NPI | 1003127218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2018-02329) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.122200) |
| 207Q00000X Family Medicine (Licence: VA 0116022791) | |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2018-10-25 |