| NPI | 1205928959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.137258) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01066595) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2026-05-20 |