| NPI | 1699794552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 18847WV) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35071519) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2015-10-15 |