| NPI | 1801027081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 8633069-1205) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 57.016205) |
| Enumeration Date | 2009-08-05 |
| Last Update Date | 2021-11-12 |