| NPI | 1407202260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101278624) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.137072) |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2023-10-12 |