| NPI | 1558646760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 23550895) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: OH 23550895) |
| 207P00000X Emergency Medicine (Licence: OH 23550895) | |
| 207R00000X Internal Medicine (Licence: OH 23550895) | |
| 208D00000X General Practice (Licence: OH 23550895) | |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2011-10-19 |