| NPI | 1104113059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X (Licence: OH 35.125078) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301502870) |
| 207R00000X Internal Medicine (Licence: OH 35.125078) | |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2025-10-01 |