| NPI | 1760730071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 079656) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 58.004471) |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2019-09-26 |