| NPI | 1689873127 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.009523) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD152457) |
| Enumeration Date | 2007-07-14 |
| Last Update Date | 2021-04-16 |