| NPI | 1205877826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35-08-3516) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 22917) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2020-12-04 |