| NPI | 1023250073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.099850) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 61005-20) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: OH 35099850) | |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2021-04-28 |