| NPI | 1215459326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.138452) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-10802) |
| Enumeration Date | 2017-07-10 |
| Last Update Date | 2022-01-25 |