| NPI | 1114570512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.145597) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 57.248052) |
| Enumeration Date | 2019-07-24 |
| Last Update Date | 2025-08-26 |