| NPI | 1588787329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35-05-1030-S) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.051030) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2020-06-05 |