NPI | 1598170219 |
---|---|
Former Name | MEGAN L SOPKO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34012697) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34-012697) |
Enumeration Date | 2014-06-23 |
Last Update Date | 2018-07-20 |