| NPI | 1104446020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.148517) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 61226) |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2025-10-29 |