| NPI | 1023244100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.147008) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101245792) |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2022-12-07 |