| NPI | 1750393757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT 59139) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34.006792) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2020-09-08 |