| NPI | 1215909791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 81494-21) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34.007011) |
| 207Q00000X Family Medicine (Licence: MN 72480) | |
| 207Q00000X Family Medicine (Licence: PA OS014887) | |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2026-05-05 |