| NPI | 1962941641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.015834) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT107600) |
| 207Q00000X Family Medicine (Licence: VA 0102206025) | |
| Enumeration Date | 2017-02-15 |
| Last Update Date | 2025-11-07 |