| NPI | 1568824530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME154989) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.135188) |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2022-11-09 |