| NPI | 1366625444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.015734) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 03244) |
| Enumeration Date | 2007-12-11 |
| Last Update Date | 2023-08-07 |