| NPI | 1508070475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 3307946) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 8892) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2022-10-30 |