| NPI | 1154068583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.017983) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 4416) |
| Enumeration Date | 2022-05-17 |
| Last Update Date | 2025-06-25 |