| NPI | 1306462221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.017756) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101027277) |
| Enumeration Date | 2020-06-17 |
| Last Update Date | 2025-03-24 |