| NPI | 1629015326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 30863) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35077950) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2021-04-09 |