| NPI | 1588003222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34C.000020) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 3902ooooox) |
| Enumeration Date | 2013-06-16 |
| Last Update Date | 2023-08-29 |