| NPI | 1407883630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.136447) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM MD2015-0263) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2025-06-16 |