| NPI | 1093445991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 59925) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.148834) |
| 208D00000X General Practice (Licence: OH 35.148834) | |
| Enumeration Date | 2022-06-14 |
| Last Update Date | 2025-05-16 |