| NPI | 1609166479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.011175) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: VA 0102204138) |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2025-04-08 |