| NPI | 1366805483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.017706) |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine (Licence: OH 34.017706) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2025-08-26 |