| NPI | 1215925433 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35067125) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: OH 35.067125) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2021-09-03 |