| NPI | 1053407973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35148567) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 32486) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2026-02-13 |