| NPI | 1770804460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.010936) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 02003933A) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2021-01-19 |