| NPI | 1760042501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: OH 35.141139) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.141139) |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2025-06-02 |