| NPI | 1073010484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2024-02968) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34.015911) |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2024-10-17 |