| NPI | 1679816383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 301103) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34012412) |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2019-10-28 |