| NPI | 1730411026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101252754) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 25145) |
| 207Q00000X Family Medicine (Licence: OH 57.015042) | |
| Enumeration Date | 2010-02-11 |
| Last Update Date | 2023-03-07 |