| NPI | 1740246073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35083658B) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 43055) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2022-09-22 |