| NPI | 1124588546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61451405) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.141776) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2024-12-02 |