| NPI | 1669685004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35. 089073) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO MD108705) |
| 207Q00000X Family Medicine (Licence: NY 260281) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2022-10-10 |