| NPI | 1073787719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 54214) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.138481) |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2023-11-03 |