| NPI | 1215357991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 30017) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35129488) |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2024-03-11 |