| NPI | 1356400410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.096326) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME97094) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2021-03-01 |