| NPI | 1083746200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO29364) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34-008943) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2021-07-21 |