| NPI | 1750844726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-167552) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 58030963) |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2024-05-01 |