| NPI | 1184624934 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301069338) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.072419) |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2023-08-04 |