| NPI | 1215503107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 57.251713) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 92444) |
| Enumeration Date | 2021-06-01 |
| Last Update Date | 2024-06-27 |