| NPI | 1700183324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 45914) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.136827) |
| Enumeration Date | 2011-02-16 |
| Last Update Date | 2021-08-31 |