| NPI | 1508449430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME167386) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.153105) |
| Enumeration Date | 2021-04-29 |
| Last Update Date | 2025-06-22 |