| NPI | 1063415859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 19601) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.090395) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2022-09-15 |