| NPI | 1396367702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.016752) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5151014611) |
| Enumeration Date | 2020-05-08 |
| Last Update Date | 2023-08-21 |