| NPI | 1134172208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.133829) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 21026) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2025-01-30 |