| NPI | 1639511595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PA OS017537) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 58.004964) |
| 208D00000X General Practice (Licence: WV 2924) | |
| Enumeration Date | 2013-07-20 |
| Last Update Date | 2018-01-05 |