| NPI | 1477713311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.012120) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 4794) |
| 207Q00000X Family Medicine (Licence: KY 03941) | |
| 207Q00000X Family Medicine (Licence: KY TP840) | |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2021-12-01 |