| NPI | 1992955736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 77084) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 47473) |
| 207Q00000X Family Medicine (Licence: OH 57.014325) | |
| 207Q00000X Family Medicine (Licence: MA 247157) | |
| Enumeration Date | 2008-09-29 |
| Last Update Date | 2022-01-07 |