| NPI | 1073530838 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34006500) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34006500) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2020-01-20 |