| NPI | 1558724559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.141449) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 11055198-1205) |
| 207Q00000X Family Medicine (Licence: CA A151864) | |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2023-11-01 |