| NPI | 1801424643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.016554) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2025042916) |
| Enumeration Date | 2020-03-28 |
| Last Update Date | 2025-10-03 |