| NPI | 1104037357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34-009525) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 58.001901) |
| Enumeration Date | 2007-05-26 |
| Last Update Date | 2020-12-21 |