| NPI | 1407240567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS025771) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34.014346) |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2026-09-08 |