| NPI | 1962459941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.007066) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34-007066) |
| 207P00000X Emergency Medicine (Licence: WV 1914) | |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2015-06-01 |