| NPI | 1205497716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.144624) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4351045648) |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2022-06-28 |