| NPI | 1730141029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 72733) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34006990) |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2023-11-10 |