| NPI | 1487628954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34007345) |
| Additional Taxonomies | 171W00000X Contractor (Licence: OH 34-007345) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2022-01-25 |