| NPI | 1518901602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2012-02056) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 02969) |
| 207Q00000X Family Medicine (Licence: OH 34.009991) | |
| 207Q00000X Family Medicine (Licence: WV 2438) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2022-04-26 |