| NPI | 1063405033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35059184) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.059184) |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2020-03-26 |