| NPI | 1629003678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02004717A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34.009993) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2020-12-17 |