| NPI | 1457607681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH RN.396648) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: OH RN.396648) |
| Enumeration Date | 2012-07-25 |
| Last Update Date | 2019-11-08 |