| NPI | 1053817353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A15191) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 58.030166) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2023-09-21 |