| NPI | 1104879006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 19273) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.081940) |
| 207Q00000X Family Medicine (Licence: KY 35592) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2024-09-24 |