| NPI | 1164043584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.017569) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 77238-21) |
| Enumeration Date | 2020-04-27 |
| Last Update Date | 2025-02-10 |