| NPI | 1194953976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.011091) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 5101018216) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2021-05-26 |