| NPI | 1962481549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV WV1479) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34006319) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2021-05-07 |