| NPI | 1649513367 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34012862) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DC DO034562) | 
| 207Q00000X Family Medicine (Licence: MD H0081197) | |
| 207Q00000X Family Medicine (Licence: WV 3508) | |
| Enumeration Date | 2013-04-01 | 
| Last Update Date | 2025-09-18 |