| NPI | 1316900541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 51203-21) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 02940) |
| 207Q00000X Family Medicine (Licence: OH 34.008438) | |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2023-09-05 |