| NPI | 1780211581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.016350) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5151014411) |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2024-03-14 |