| NPI | 1700065919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35093073) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 57.013264) |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2023-07-05 |