NPI | 1770565293 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: OH 35-071191) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35-071191) |
Enumeration Date | 2005-11-18 |
Last Update Date | 2021-09-14 |