| NPI | 1134165608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34007533) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 02924) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2022-01-25 |