| NPI | 1457315947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 105060) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35-08-3111-J) |
| 207Q00000X Family Medicine (Licence: NC 2010-01703) | |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2025-09-16 |