| NPI | 1922268978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2015-01035) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35095053) |
| 207Q00000X Family Medicine (Licence: VA 0101258063) | |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2025-12-09 |