| NPI | 1043339047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.094684) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: OH 35.094684) |
| 207Q00000X Family Medicine (Licence: MI 4301091117) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2021-12-06 |