| NPI | 1942673520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV Aprn74052) |
| Additional Taxonomies | 103TP0016X Psychologist, Prescribing (Medical) (Licence: OH 18351) |
| Enumeration Date | 2015-11-04 |
| Last Update Date | 2024-06-11 |