| NPI | 1760627913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.125997) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD441543) |
| Enumeration Date | 2008-12-02 |
| Last Update Date | 2023-03-07 |