| NPI | 1669578837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34008929) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101015362) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2024-07-12 |