| NPI | 1558654020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.133520) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN MD0000050361) |
| Enumeration Date | 2011-05-17 |
| Last Update Date | 2023-11-07 |