| NPI | 1780249540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.018466) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 2324) |
| Enumeration Date | 2019-05-07 |
| Last Update Date | 2026-05-07 |