| NPI | 1700235983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.136600) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC MMD.39729 LL) |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2025-01-02 |