| NPI | 1427696400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301104538) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35056135) |
| Enumeration Date | 2019-12-20 |
| Last Update Date | 2019-12-20 |