| NPI | 1639185259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.070855) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 40681) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2021-09-30 |