| NPI | 1376525667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 39086) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35-06-7352-C) |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2022-07-21 |