| NPI | 1306406459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34016078) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5151013953) |
| 207Q00000X Family Medicine (Licence: MI 5101026396) | |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2022-10-21 |