| NPI | 1013912179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 3582754) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35-082754) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2022-12-06 |