| NPI | 1598769069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35074933) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 39281) |
| Enumeration Date | 2005-06-11 |
| Last Update Date | 2023-10-19 |