| NPI | 1770163149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 079252) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 57.251478) |
| Enumeration Date | 2021-04-10 |
| Last Update Date | 2024-09-11 |