| NPI | 1184864431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34-009871) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS-016056) |
| Enumeration Date | 2009-02-26 |
| Last Update Date | 2022-10-17 |