| NPI | 1073192480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.151692) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301504698) |
| Enumeration Date | 2021-04-04 |
| Last Update Date | 2024-09-13 |