| NPI | 1225563661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.139838) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 57.029942) |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2020-06-12 |