| NPI | 1366409328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2026-03140) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35073109) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2026-08-04 |