| NPI | 1174938997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34012755) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34.012755) |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2022-11-14 |