| NPI | 1477914893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL DO.2157) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34.013055) |
| Enumeration Date | 2016-03-12 |
| Last Update Date | 2020-07-15 |