| NPI | 1568790046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO157503) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34009672) |
| Enumeration Date | 2009-11-23 |
| Last Update Date | 2022-05-03 |