| NPI | 1346601242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.139884) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-41320) |
| Enumeration Date | 2016-03-19 |
| Last Update Date | 2021-06-17 |