| NPI | 1619592987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.017107) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 94295) |
| Enumeration Date | 2020-06-12 |
| Last Update Date | 2024-09-13 |