| NPI | 1982745675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.093878) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25 MA07655500) |
| 207Q00000X Family Medicine (Licence: PA MD 0422608) | |
| 207Q00000X Family Medicine (Licence: TN MD0000019768) | |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2022-06-06 |