| NPI | 1184191587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 022761) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 2353091) |
| 207Q00000X Family Medicine (Licence: KY 3012364) | |
| 207Q00000X Family Medicine (Licence: SC 24201) | |
| 207Q00000X Family Medicine (Licence: NH 114923-23) | |
| 207Q00000X Family Medicine (Licence: NY 356596) | |
| Enumeration Date | 2018-10-24 |
| Last Update Date | 2025-10-11 |