| NPI | 1811015704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2010-00107) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35089606) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2023-03-07 |