| NPI | 1487094694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.013343) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 39103) |
| 207Q00000X Family Medicine (Licence: WV #ED0383A) | |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2018-05-15 |