| NPI | 1578966396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S8394) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34.012506) |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2023-04-28 |