| NPI | 1417040155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.085472) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME159307) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2024-10-29 |