| NPI | 1730440314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34012281) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH AP2282058A17) |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2022-01-25 |