| NPI | 1780797738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 22842) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35088413) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2022-04-06 |