| NPI | 1649261876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301510115) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35072147E) |
| 207Q00000X Family Medicine (Licence: OH 35-072147) | |
| Enumeration Date | 2005-11-05 |
| Last Update Date | 2024-01-26 |