| NPI | 1164432001 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.007818)  | 
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: OH 34007818)  | 
| Enumeration Date | 2006-08-09 | 
| Last Update Date | 2025-04-23 |