| NPI | 1508810961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 1302) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.005706) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2020-11-25 |