| NPI | 1184600652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 42588) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: OH 42588) |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2023-11-03 |