| NPI | 1255397139 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS16594) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34.006712) | 
| Enumeration Date | 2006-04-21 | 
| Last Update Date | 2024-06-07 |